Workers' compensation pharmacy fee schedule - Simple prescription
NOTICE: The February 20, 2019 data file will remain in effect until the DWC has adopted updates to the Pharmaceutical Fee Schedule that are necessary in light of changes in the Medi-Cal Pharmacy Fee Schedule payment methodology. DWC will be holding a public hearing and accepting public comment on the fee schedule revisions. Weekly updates to the data file will resume after the revised fee schedule methodology is adopted. Notices relating to the Pharmaceutical Fee Schedule rulemaking action will be sent to the DWC Newsline mailing list. You may subscribe to the DWC Newsline mailing list on the DIR subscription web page.
This data is provided as a service to the workers' compensation community. Please send comments or questions to DWCFeeSchedule@dir.ca.gov.
You may download the Medi-Cal pharmacy fee rates (Zip file, 6.40 MB, updated 03/08/2019 - also available via ftp to www.dir.ca.gov, anonymous login). The file's record layout and instructions are included in the zip file, and may also be viewed here.
You may look up the current price of simple prescriptions by completing the form below and clicking "price." For compound prescription pricing, click here. If you are working from a file with 10 digit NDC numbers, please click here.
All fields except "nursing home" and "no substitutions" are required
Pricing is from data as of 2/20/2019.
Workers' compensation pharmaceutical fee schedule — Physician dispensed pharmaceuticals
Legislation that became effective on January 1, 2012 places new caps on fees for pharmaceuticals dispensed by physicians. These new caps are contained in Labor Code section 5307.1.